At this writing, the Cleveland Major Research Project is in the fourth year of operation. Our goals are unchanged. Significant maturation has occurred in the research protocols. We continue to study aberrant maternal and fetal metabolic systems with emphasis on the diabetic mother, fetus, and neonate; the intrauterine growth retarded fetus and neonate; and the prematurely born infant. In this research application metabolic abnormalities are now more closely linked with key fetal systems such as the fetal brain, fetal heart, snd with neonatal neurologic development in order to determine whether demonstrated disordered metabolic systems correlate with disordered organ growth and function. As treatment is applied, most specifically in diabetic patient care, but also in the growth retarded fetus, the effects of the interventions will be related not only to neonatal outcome but to the described study systems.